r/depressionregimens

Helo guys , chronic depression & anxiety , DP DR , burnout , low sleep quality always waking up like I haven't slept at all , hypervigilance and hyperexcitability , social anxiety , obsessive paranoid thoughts , low energy apathy and low motivation since almost 8 years now

I have been through numerous meds including SSRI's , snri's , antipsychotics , mood stabilizers , etc without really much succes

I am now on clomipramine 225mg wich does nothing but give me horrible side effects,( awful constipation to the point of bleeding , excessive sweating its so unbearable ) lamictal 200mg a day .

My doctor is going to switch me to prozac and keep the lamictal and add Seroquel XR at night since im a bit paranoid & having no sleep at all

My question guys what other options do I have to try ? I honestly feel like the Lamictal isn't doing much at all ...

I will ask my doc to add a low dose lithium and see how it goes . Also MAOI's are not available where I live , Wellbutrin didn't work either .

My next appointment which is tomorrow i am going to be on : prozac , lamictal , Seroquel xr and low dose Lithium

I am thinking of adding l tryptophan to my regimen too

So I’ve been diagnosed with depression for 5 years and been on antidepressants since I was like 13 years old. Over that time I’ve tried a few antidepressants (Prozac, Zoloft, lexapro, Wellbutrin, buspar, Effexor, cymbalta, remeron) and nothing has seened to really “work” for me. ATM I’m on lexapro and remeron, but I’m now realizing that idk what it really means to having a medication work. Like obvi it’s not a magic fix but then how do u actually notice a difference in urself and the way u feel? The only time a medication has had a visible effect on me was my first trial of lexapro where it made me less anxious, less drowsy and overall more functional but Idk if I’ll ever experience a medication like that again so that shouldnt be my standard. Does anyone know like how to know when a medication works vs doesn’t work? tysm

Its all too common in stories where basically someone is very high functioning all their life and then suddenly they take some substance or get a virus or even in rare cases from an intense stressor or out of nowhere develop debilitating anhedonia that seems to respond to nothing. The system just snaps. . Its like a nervous system shur down type thing but the reality is the meme “oh ignore it, do nervous system regulation exercises, etc” does not work

This is clearly a different entity than whatever is being called as depressive anhedonia.

Often times there are other autonomic symptoms too like gastroparesis, exercise intolerance, POTS, and more. Some people develop sensitivities where one small thing causes the system to crash further

Its a very severe state and psychiatry is completely missing it. Even the “anhedonia” literature does not describe this kind of severity of consummatory anhedonia with substance blockage, blank mind, sensitivities. They still list CBT and behavior activation or the new meme “positive affect therapy” which are all just insulting for what is otherwise basically a medical emergency.

What is it going to take for real recognition of this severe state?

Its one of the most gaslit things in the field right now.

Atypical depression is a subtype of major depressive disorder different from melancholic depression. The typical features (along with core features of MDD): mood reactivity, weight gain, increased appetite, laden paralysis (feeling heavy in arms and legs), and sensitivity to interpersonal rejection and criticism, sometimes also anxiety.

I have heard about studies that say MAOIs work best in this subtype. But the studies are mixed and inconclusive as there is conflicting evidence. The other day I saw someone on the zoloft sub, where sertraline worked very well for their atypical depression, which is a SSRI.

Many clinicians online say that the subtypes don't have much implication on treatment of MDD.

If you had atypical features (even if not officially subtyped diagnostically), which meds worked for you?

Which medication changed your life for the better?

Also, how did it change? What were the changes that made you realise you were coming out of the hole? Were there symptoms that you didn't realise you had while you were depressed, only to realise once they got obliterated??

I'm very new to taking anti depressants and seeing psychiatrists.

I initially started seeing her for depression/anxiety and alcohol abuse.

She started me on citalopram 20mg, about week 3 I was experiencing sexual side effects, delayed orgasm no libido, emotional blunting, anhedonia, lack of motivation and increased hunger.

It did resolve my anxiety and insomnia though.

At our one month follow up I expressed the issues with the side e and she started me on pristiq after a 3 day taper.

I immediately started having sleep disturbances along with irritability and aggression.

I reached out to her regarding the side effects stating she wished to follow up in a month.

After doing more research on SNRI's withdrawals and already having severe side effects I stopped and went back to citalopram.

After meeting with her again today she wanted to add a low dose of abilify and stay on 10 mg of citalopram.

During my own research it seemed like Wellbutrin may be a better fit as it would help offset some of the emotional blunting and motivational issues as well as sexual side effects.

She stated that she was hesitant to prescribe it to me as it may cause insomnia which is a high concern and that it was activating in May flare my anxiety, both of which I am willing to deal with. Still have not heard back from her to make a decision.

I don't understand why she would start me on a lower dose of an SSRI and take another medication that amplifies said medication if I was already unhappy with a lot of the effects, I'm not sure if I just need to see a new doctor or follow her suggestion

I'm also worried that she is disregarding my lack of motivation and anhedonia as depression and not side effects of the medication. One of the few things I do know well is my body and this is not how I experienced depression.

I do want to add that I am extremely bad at advocating for myself and this is the first time in my adult life that I have sought help and it's kind of just got me more upset and losing faith in the whole system.

I'm thinking of bringing up this medication the next time I see my psychiatrist. Read good things about it. Am interested in reading experiences from people in this subreddit

Did anyone benefit going in patient? Did it help you get the right meds? I really don’t even know what to do anymore.

Hi guys,

I have stage 5 treatment resistant depression, and I'm wondering what options I have.

I’ve tried SSRIs, SNRIs, TCAs, MAOIs, ketamine, ECT, rTMS, psychedelics, neurofeedback, and dTMS.

Of them, I didn’t do a complete trial with ECT and dTMS.

For ECT I did 4 sessions 5 years ago My seizures were extremely long and the first two had to be stopped with midazolam. The next two were very long but stopped within 80 seconds. ECT made my depression worse and gave me profound anhedonia and sexual dysfunction for eight months after. The ECT psychiatrist said that even though that I did 4 sessions, that more wouldn’t help.

My current psychiatrist says that a full course of 6-12 sessions may be more appropriate and that me feeling worse was just because of the seizures, but I feel like given how bad it made me feel that doing a full course isn’t worth it/won’t work?

For dTMS, the psychiatrist did a qEEG and found that my frontal cortex was overactive. She prescribed an inhibitory protocol using the H1 and H7 helmet. It made my mood feel worse and she stated that the standard FDA protocol wouldn’t help either.

I also tried psychedelics (LSD) and it didn’t help and I had a bad trip with no visuals.

My questions are:

1. Is ECT worth retrying?
2. Is dTMS worth retrying?
3. Are psychedelic clinical trials worth retrying?
4. Are there any other treatment options for me?

Hello all. I’ll keep it short. I literally have been on every medication. I have done TMS, ECT, Spravato… every combination of drugs multiple times, it’s been a rough 29 years. My depression has become anhedonic, doing literally anything feels impossible and awful. To be completely honest, there was even a time where I couldn’t get off the couch to go to the bathroom and I coughed and I peed my pants because I had held my bladder for so long. Everything seems like climbing a mountain Motivation is completely nonexistent. Don’t even get me started on anything remotely close to joy. I am more miserable than ever, so my doctor and I decided to try pramipexole. I told her I feel like while yes I think I need serotonin help but I feel like what I’m really lacking is dopamine. So we added it to my 1.5 milligram vraylar, once a day auvelity, 60 milligram cymbalta, 70 milligram vyvanse and 250 milligram Nuvigil… I also have extreme hypersomnia. Any insight and experiences would be so much appreciated! Thank you!

Most antidepressants can increase weight as a side effect even though they can work beautifully for the original disorder that is being treated.

Depression itself can cause weight gain (weight loss for some). Those who were already overweight due to their mental health condition, which medicines worked for you and didn't affect weight that much??

I’ve been on Wellbutrin for almost five years now and it’s the only antidepressant that ever did anything for my depression. It works tremendously for my SCT and executive dysfunction and helps me be more functional and productive on a daily basis. It was the only antidepressant that was ever life changing for me because I was unable to function properly without it before.

Unfortunately I had to back of the dose recently to 150 mg after being on 300 mg for almost four years. 300 mg worked very well for my depression for a very long time. But unfortunately it started to overstimulate me in various ways I couldn’t tolerate it anymore. So I had to back off to 150 mg just because 300 mg started to give me some weird side effects I never used to get from it before or this extent. It started to give me side effects like frequent thirst, frequent urination, dry mouth, dizziness, vertigo, hot flashes, headaches, burning sensations, increased sweating, heart palpitations, rapid heartbeat, facial twitches, jitteriness, hypervigilance, horrible insomnia and sleep disturbances. A whole cluster of side effects and when these side effects started to escalate I dropped back the dose to 150 mg.

Now I’ve been on 150 mg for 7 weeks and I can already tell the difference. My depression has gotten noticeably worse since backing off the dose and I’m having more mood swings and feel a huge feeling of emptiness all the time. And most of the side effects I had at 300 mg did lessen ever since I backed off the dose, but they did not disappear completely, they just lessened in intensity. And the most bothering side effects I’ve been dealing with for months is horrible insomnia and sleep disturbances. And I really hoped backing off the dose would atleast make the insomnia and sleep disturbances go away, but unfortunately it did not. So not only is my mood worse now and I’ve lost interest in things that used to matter to me. And I’m more socially withdrawn now from everything. The side effects did not go away completely and the insomnia and anxiety is still there.

When I used to take Wellbutrin with Prozac two years ago I had none of these issues. I took 300 mg Wellbutrin and 20 mg Prozac for two years and I had none of these side effects and the insomnia wasn’t there either. And ever since I removed Prozac that’s when all of this came up for me. So I obviously used to tolerate it better when I took it with Prozac.

I know this text got a little bit too long. But I just needed to explain all of it first. So like my original question was. Do you think I should go back again to combination therapy. And I mean, if Prozac truly removed these side effects for me and the insomnia wasn’t there either when I took them together, do you think this is something I should bring up with a doctor again and consider going back to? Because I really don’t want to remove Wellbutrin because it’s the only antidepressant that ever did anything for me. I’m just afraid my body can’t tolerate it all by itself anymore.

Would like to hear your thoughts and opinions about this.

I have stress induced melancholic depression (anhedonia). I just graduated college and started an engineering job however I am severely struggling to function. It’s really hard for me to focus, recall facts, or talk to people as I am completely numb. It is humiliating because everyone around me is functioning normal and I can barely form sentences or hold eye contact. I’m falling behind on my work and trying not to let it show. I’m fucking trying to keep up and act normal but it’s so fucking hard when you feel numb and unable to focus. It’s a living hell.

A close family member of mine has a very similar depression and has remained functional somehow for many years. They take a pretty high dose of a stimulant to keep them functioning at work and sleep medication to sleep at night. They also have told me that if I quit it won’t fix the depression and they would consider me non-functional and unable to stay at their house if I quit. I know they want the best for me but it’s so fucking hard to act normal and be productive.

I’m starting the stimulant but it’s not doing much as it’s a very low dose. If I quit I’m severely stunting my career. I know people say to take time off to get treatment but depression doesnt work like that. I’m going to feel the same after treatment. I already fucking tried taking a break and doing tms, ketamine and a number of ssri/snri’s. The next step is ect, tricyclic, or upping my stimulant. But those all take large amounts of time.

So I feel severely stuck and try to act like nothing is wrong.

Hi everyone,

I’m looking for personal experiences and thoughts about this combination.

Im F(36) was on SSRIs/SNRIs and CBT for around 10 years, and they didn’t help at all in fact it made the depressive episodes worse, gained a tremendous amount of weight on, and it caused hypothyroidism among other things.

I stopped antidepressants for about 5 years, then started Wellbutrin/bupropion about a year ago after a severe depressive episode that lasted 8 months.

I’m now on 300 mg SR, EMDR therapy, and it has helped with depression and CPTSD immensely.

And also, i take a small quarter dose of Seroquel/quetiapine for sleep

However, I still struggle with emotional flatness, anhedonia, freeze/shutdown mode, tiredness, and executive dysfunction. I can manage necessities, but I still feel stuck and not fully functional, especially with socializing, trying new things, going to the gym, and maintaining my health… etc.

I also was diagnosed with autism as an adult, which may be part of the freeze/executive dysfunction issue.

My psychiatrist prescribed Rexulti/brexpiprazole as an add-on to Wellbutrin, but I’m apprehensive. I’m scared it could undo the progress I’ve made or cause side effects like akathisia, emotional blunting, fatigue, or weight gain.

Has anyone added Rexulti to Wellbutrin for residual depression, anhedonia, freeze/shutdown, or executive dysfunction? Did it help or make things worse? What dose did you start on, and how long did it take to notice effects?

I get triggered every time I come in contact with mobile phones because I've been through a related traumatic event multiple times because of a family member. Is there any way to make it stop? Like EMDR therapy or CBT or medication? What has worked for you?